Wondering if an In-Office PCR Testing Lab is right for you?

1

First, tell us your name.* This field is required.

First Name

Last Name

Suffix

2

What email address can we reach you?* This field is required.We do not sell your information to third-parties.

example@example.com

3

Tell us more about your practice.

4

Does your practice have an 8x10' space available, or are you able to rent a small space in your building, to set up the lab equipment?* This field is required.

YESNO

6

How many lab panels do you order per day?Enter amount for each per line.

7

What is the approximate insurance mix that you see at your practice?Ex. 30% Medicare, 10% Medicaid, 30% BCBS HMO, 10% Aetna HMO, 20% PPO

8

Before you go, at what phone number can we reach you?Contact Number

Please enter a valid phone number.